Effect of Hypertension on Outcomes of Adult Inpatients with COVID-19 in Wuhan, China: A Propensity Score–matching Analysis

Abstract

Background: Previous studies have shown that Coronavirus Disease 2019 (COVID-19) patients with underlying comorbidities can have worse outcomes. However, the effect of hypertension on outcomes of COVID-19 patients remains unclear.Research Question: The aim of this study was to explore the effect of hypertension on the outcomes of patients with COVID-19 by using propensity score–matching (PSM) analysis.Study Design and Methods: Participants enrolled in this study were patients with COVID-19 who had been hospitalized at the Central Hospital of Wuhan, China. Chronic comorbidities and laboratory and radiological data were reviewed; patient outcomes and lengths of stay were obtained from discharge records. We used the Cox proportional-hazard model (CPHM) to analyze the effect of hypertension on these patients’ outcomes and PSM analysis to further validate the abovementioned effect.Results: A total of 226 patients with COVID-19 were enrolled in this study, of whom 176 survived and 50 died. The proportion of patients with hypertension among non-survivors was higher than that among survivors (26.70% vs. 74.00%; P < 0.001). Results obtained via CPHM showed that hypertension could increase risk of mortality in COVID-19 patients (hazard ratio 3.317; 95% CI [1.709–6.440]; P < 0.001). Increased D-dimer levels and higher ratio of neutrophils to lymphocytes (N/L) were also found to increase these patients’ mortality risk. After matching on propensity score, we still came to similar conclusions. After we applied the same method in critically ill patients, we found that hypertension also increased risk of death in patients with severe COVID-19.Conclusion: Hypertension, increased D-dimer and the ratio of neutrophil to lymphocyte increased mortality in patients with COVID-19, with hypertension in particular.

The relationship between self-assessment living standard and mental health among the older in rural China: the mediating role of sleep quality

“…In addition, 48.4% of participants with PSQI scores above 7, and 2.5% of participants reported serious sleep problems, which was higher than the results of Ding Kunxiang's study [55]. This may be due to the different time points we surveyed and changes in the social environment in rural areas [56].…”

COVID-19 and Cardiovascular Comorbidities

“…A number of retrospective studies as well as propensity score matched and meta-analyses showed that hypertension could significantly increase severity and fatality of COVID-19 83 84 85 86 87 88 89 90 . In a retrospective observational study, COVID-19 patients with hypertension had a higher mortality rate (24.8% vs. 15.2%), a higher proportion of severe patients (63.7% vs. 42.1%), a higher proportion of patients receiving non-invasive mechanical ventilation (16.8% vs. 7.6%), and a higher proportion of patients transferred to the intensive care unit (ICU) (23.9% vs. 12.2%).…”

“…Adjusting for confounders, such age, gender, presence of CVD, diabetes or chronic obstructive pulmonary disease (COPD) did not affect the association 86 . A propensity-score matched analysis including COVID-19 patients from Wuhan showed that patients with hypertension had significantly higher risk of death (hazard ratio (HR) 2.679;95% CI [1.237–5.805]; P=0.012;) 87 .…”

Metformin Is Associated with Favorable Outcomes in Patients with COVID-19 and Type 2 Diabetes Mellitus

“…Risk factors and comorbidities linked to worse outcomes for COVID-19 patients have been identified. These include old age 5 , chronic pulmonary disease and smoking 6 , cardiovascular disease 6 , hypertension 7 , diabetes mellitus and obesity 8 . Patients with pre-existing diabetes mellitus, depending on nations and patient cohorts, have been reported to account for patients with COVID-19 from 5-20% in China, 17% in Lombardy in Italy to 33% in the US 1-5 .…”